What are the effects of high DA administration?

A1- Vasoconstriction and increased blood pressure

What are the indications for DA?

What are the precautions for DA administration?

1) Hypovolemia should be corrected before DA use 2) Tachycardia, angina, arrhythmia, headache and HTN3) Extravasation may cause ischemic necrosis and sloughing4) Avoid with MAOI or tricyclic antidepressants

67

What is ephedrine?

Mixed-acting adrenoceptor agonist

68

What is unique about ephedrine?

- First orally active sympathomimetic - Banned b/c of safety concerns

69

What is the clinical use for PSEUDOephedrine?

Nasal decongestant

70

What are the two indirect acting releasing agents?

Amphetamine Tyramine

71

What is amphetamine's mechanism of action?

- Transported into the nerve terminal by NET1- Taken up into pre-synaptic vesicles - Displaces NE from the vesicle - NE escapes via NET1

What is the desired feature of a beta-blocker in regards to lipid solubility? Why?

What are the four factors related to lipid solubility that need to be considered prescribing a beta blocker?

1) Plasma levels/ duration of action 2) CNS 3) Kidney4) Age/ liver

119

What two drugs have ISA? What class are they?

Pindolol= 1st genAcebutolol= 2nd gen.

120

What should you do in a HTN patient with asthma that is not responding to selective beta-blockade with Metoprolol?

- Add another selective beta blocker- DON'T increase dose

121

Why are beta blockers given in CHF? Aren't beta-blockers going to further decrease CO?

Despite being a negative ionotrope, beta blockers are given b/c there is an increase in circulating catecholamines to compensate for poor CO. Beta-1 receptors are over-activated chronically and downregulate. Low does Beta-1 "protects" receptors from overactivation without diminishing contractility.

122

What is the mnemonic to remember the cardio-selective beta-blockers?

AMEBA

AtenololMetoprololEsmolol Beliprolol Acebutolol

123

What type of beta blockers are affected by kidney and liver function?

Lipophillic

124

How do beta-blockers mask the symptoms hypoglycemia?

1) DM patient develops hypoglycemia2) Physical signs of hypoglycemia include: - Increased HR - Palpitations - Agitation3) Without these symptoms, patient does NOT know that they are beginning to become hypoglycemic

125

What symptoms of hypoglycemia is NOT masked by beta-blockers that patient can be weary of?